STIs Flashcards
What Sx are associated with urethritis?
Discharge
Frequency/dysuria
Dyspareunia (women)
Meatitis
Which of gonorrhoea and chlamydia is usually asymptomatic and which is often symptomatic?
Gonorrhoea usually Sx
Chlamydia usually no Sx
Is gonorrhoea usually symptomatic?
Yes
Is chlamydia usually symptomatic?
No
What investigations are appropriate for urethritis?
Gram stain discharge swabs looking for WBCs
Presence of what on gram stain indicates gonorrhoea? Absence = what?
Presence of gram negative intracellular diplococci
Absence = non-gonococcal urethritis
What is the next step after identifying presence of gonorrhoea infection?
Culture and sensitivity for neisseria gonorrhoea
What investigation is used for identifying both chlamydia and gonorrhoea?
PCR
What is urethritis if not caused by gonorrhoea or chlamydia?
Non-specific urethritis
Often mycoplasma or ureaplasma
Treatment for gonorrhoea?
Ceftriaxone 500mg OD (/cefexime 400mg PO)
And azithromycin 1g single dose
Alternatively ciprofloxacin/ofloxacin BD for 7 days
Treatment for chlamydia?
Doxycycline 100mg BD for 7 days
Or azithromycin 1g PO stat
What are the 2 most common causes of urethritis?
Gonorrhoea
Chlamydia
3 common infectious causes of vaginal discharge?
BV
Trichomonas
Candida
What is the pathophysiology behind BV?
Anaerobic gardnerella vaginalis replace lactobacilli in vagina
Describe the discharge associated with BV?
Malodorous, grey, ‘dirty’
What is Fitz-Hugh-Curtis syndrome?
Perihepatitis with violin string adhesions, caused by gonorrhoea spread via paracolic gutters
Complications of gonorrhoea or chlamydia infection?
Local abscess/Bartholinitis in women Epididymo-orchitis or prostatitis in men PID Disseminated gonococcal infection (FHC syndrome) Neonatal ophthalmia/conjunctivitis
In what 2 groups is BV more common in?
WSW and IVDU
Ix to identify BV?
Often clinical - KOH ‘sniff test’
Clue cells on smear
Rx for BV if required?
Metronidazole
Describe the Sx associated with vaginal candidiasis?
Vulvovaginitis - itch worse at night, non-malodorous white discharge, painful fissuring
RFs for candidiasis?
Poor hygiene
Immunosuppression - DM, pregnancy, HIV
What can a film show when sample is positive for candidiasis?
Spores and pseduohyphae
Rx for candidiasis?
Pessary - clotrimazole
Single dose fluconazole
What is Trichomonas infection?
Causes very offensive vaginal discharge and itching
Is trichomonas symptomatic in men? Under what circumstances?
Often no unless Afro-Caribbean
Results on film positive for trichomonas?
Motile flagellated protozoa on wet slide
Rx for trichomonas?
Metronidazole
2 common causes of genital ulcers?
HSV infection
Syphillis - treponema pallidum
Bacterial cause of chlamydia?
Chlamydia trachomatis
2 types of HSV causing ulcers? Which is which?
Oral = HSV1
Genital = HSV2
Although the 2 are interchangeable
What diagnostic method is used for coding HSV infection?
PCR
Rx (if necessary) for HSV?
Aciclovir topical
Causative microorganism of Syphillis?
Treponema pallidum
What is the first sore that presents in a Syphillis infection called?
Primary chankre
What rash is commonly associated with Syphillis?
Palmarplantar
Someone presents with a sore, rash, painless lymphadenopathy. What 2 things should be considered?
HIV
Syphillis
Possible manifestations for early (infectious) period of Syphillis (
Primary, secondary or early latent
Manifestations of late (non-infectious) period of Syphillis (>2 years)?
Late latent
CV infection
Neurosyphillis
Gummatous liver
What organism may be visible on microscopy in a Syphillis infection?
Spirochete
3 tests for Syphillis in the lab?
PCR
Serology - VDRL (nonspecific) and treponemal IgG EIA
2 serological tests for Syphillis?
VDRL
Treponemal IgG EIA
Rx for Syphillis?
Benzathine penicillin injection
Or doxycycline
Tropical infections causing genital warts?
Chancroid
Lymphogranuloma (tropical chlamydia with HIV association)
What are the common causative agents of genital warts?
HPV 6 and 11
What is Gardasil protective against?
HPV 6, 11, 16 and 18
Rx approaches for genital warts?
Freezing (cryotherapy)
Cautery
Podophyllotoxin
Imiquimod
What is molloscum contagiosum?
Can cause genital warts but also commonly spread around schoolyards eg on arms